Talking with Amohia Boulton part-2

Amohia Boulton (Ngāti Ranginui, Ngai te Rangi, Ngāti Pukenga, Ngāti Mutunga) is a Senior Researcher and Associate Director at Whakauae Research for Māori Health and Development, a small tribally-owned and mandated Iwi research centre based in Whanganui.

In ‘Talking with Amohia Boulton part 1,‘ we got to hear about her experiences as a researcher working in a Whānau Ora work space, how she came to work in this area and what this has meant for her.

In this piece we will get a more in-depth feel for what she has gained from her experiences working with different providers, the methods that she has incorporated in her work and some advice for researchers and evaluators who are currently or planning on working with whānau.

So what are some things that you have learned over the years?

AB: If I think about the personal learnings, I guess I know one of the things that I’m not particularly good with is flexibility. One of the things that [has been a] challenge for me, even working in this organisation, is to learn [how to be flexible]. I had to learn how to adapt the research plan to different situations in order [to ] get high quality information. [We had to make sure that] the quality remains high even though there may have been methodological things that may have changed along the way or we may have had to adapt our timing to work in with the provider.

In terms of Whānau Ora more broadly, there is a lot that I have learned. Because I’m still in it, down and immersed in the detail, I think probably that reflection time won’t happen until a bit later. [What I have learned already] is that there is a whole commitment, desire and drive on the part of providers, community and whānau for this to work. There is a whole lot of energy out there too and it would be really short-sighted of us to get to a point where it kind of ends. I know it’s going to end because these things have a timeframe in terms of politics, but I think if we want to see all the outcomes and benefits of all the effort that’s gone in, we need a bit more time. Communities have been asked to do a huge thing, turn around years of being delivered to without having any voice and we’re asking, in a very short space of time, for that system to be flipped on its head and then immediately see outcomes from that. I think that’s naïve to think that will happen [in a short space of time] and I think it’s naïve to think that will happen without commitment at all levels of government, from all sectors of government.

While Whānau Ora might be equated with the Te Puni Kōkiri initiative, [we need] the likes of education, housing, justice, health, to all come on board and truly embrace the idea that whānau drive their own desires and ambitions. Once state agencies understand that [whānau know what their desires and ambitions are] and relinquish control, then we’ll be able to see greater outcomes from this idea of Whānau Ora. So I think there are a number of challenges still ahead.

With your Whānau Ora mahi, what sort of methods have you used?

AB: We used a lot of methods really. When we first started we were told it was going to be action research and we went into the process thinking it was going to be that, so the way that we developed our research plans initially was very much around having cycles of feedback quickly. As the research rolled out we came to understand that Te Puni Kōkiri wanted more of an evaluation type approach to what we were doing. That’s what I mean when I say that we had to adapt to what we thought we were going to do. Each of the sites themselves directed what they needed to get out of the process. We were guided by them in terms of what was the most useful for them.

In each of our sites we had different methods and methodology that we used. We have tried to stay true to the Kaupapa of getting timely information and getting it back to the providers so that they can use it in their own work. At the same time we’ve also married that with a participatory evaluation approach to our work.

There are some learnings that we have to interpret according to the world-view that we bring, which is definitely Māori centred- Kaupapa Māori. [The work] is for Māori, so we are always looking at our data in that sense. Within that there are lots of different methods again because we work within different sites and often [need to cater to that difference].

[An example of catering a method for a specific case] is with the Heretaunga site. They did a lot of organisational restructure up front and so we’re only really now getting to the point where we’re getting some whānau plans done. We needed to demonstrate a way that whānau were engaging with the Taiwhenua and what was happening. One of our researchers, Gill Potaka-Osborne developed, what we’re calling whānau stories or whānau vignettes to describe the whānau journey. These vignettes are their stories and show what the Taiwhenua were doing with whānau, and how the lives of whānau have changed as a consequence. Whānau stories are a nice pictoral way of demonstrating [the developments that are being made with whānau]. We hope to present this method of representing the whānau journey at the Health Research Council’s upcoming Hui Whakapiripiri in Auckland, in July.

Other methodology stuff is pretty standard: key informant interviewing, doing document analysis, focus groups, interviewing whānau and just taking data from lots of different sources and then trying to triangulate and see if the data matches up.

The other thing that was kind of good for us is that as the three sites were going we had team meetings with the academic leads across the sites. We all came together and discussed what the challenges were and how we were overcoming them in our different research sites. So we could all learn what was going on in different places and we found that really valuable too [to be able to bounce ideas off each other]. When you’re out doing your fieldwork it’s kind of isolating if you don’t have some way of touching back with everyone else, so those regular meetings were really good.

Do you have any general advice for people who are just entering the field and doing research with different whānau?

AB: I guess I’d hark back to that idea that at the end of the day whānau are not dumb, they know what they want, they know what they need and they know what their priorities are. When you work with whānau, despite any preconceptions that you might have, you have to leave those aside and really listen to what whānau are telling you because they do know and they will tell you in their own way and you have to be open to hear it. I know Fiona Cram talks about that, you have to sit there and just listen before you leap in and start talking… We have to be open enough to hear them.

So Heather and I have [always] had quite a bit of interest in [Whānau ora] from a research point of view. We have been writing papers on this over time. They’re not necessarily from the action research because we can’t do that as yet. The stuff that we have written has been from other projects where there has been a Whānau Ora lens.

What conclusions did you come to from that?

AB: We had a couple of studies where we were looking at a Whānau Ora approach and what that means in terms of health servicesand wellbeing for families and we compared the responses from the participants in those two studies with what the Whānau Ora Taskforce was saying Whānau Ora was. Our analysis indicated a strong degree of concordance in four of the six Taskforce goals, namely healthy whānau lifestyles, full participation in society, economic security, and whānau cohesion. Only moderate concordance was noted in participation in te ao Māori goal and we found weak concordance in the whānauself-management goal. Our analysis highlighted that for Māori whānau there is not, as yet, a globally understood definition of whānau ora. Many of the families we interviewed were able to discuss elements that contributed to a sense of whānau ora for their family. However, it was equally clear that achieving a state of whānau ora was both time and context dependent and differed from family to family depending on where along a continuum of financial, social and cultural security, and confidence they placed themselves at any one time. At a central agency level we concluded that there were many different understandings of Whānau Ora.. So [Te Puni Kōkiri’s understanding of Whanau Ora] may be different to what the Ministry of Social Development (MSD) understands Whānau Ora to be and that makes it quite a complex space to work in. Given that the bulk of the health and social service budget in any one year is managed by mainstream policy ministries and departments, a crucial challenge to the success of improving Māori health and wellbeing outcomes will be the degree to which these mainstream state sector agencies can come to grips with the concept and adjust their service delivery approach to one that better meets the needs of whānau.

Final comments:

It has been a real privilege to work with the providers and the whānau that we have worked with. We are very conscious of how much time this has taken from providers and how much time it takes from their work. They are the ones on the ground delivering to families and we know how that time is valuable and [I’m sure there are more pressing issues in the lives of these families] than needing to talk to a researcher.So we’re really honoured and privileged that they all gave up their time to inform this work which we think as researchers is incredibly important and can in the long term lead to differences and real improvements for Māori. That’s why we do it.